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Shoulder Problems after Cervical Surgery

AnonymousUserAAnonymousUser Posts: 49,623
edited 06/11/2012 - 7:25 AM in Neck Pain: Cervical
I thought I would see what kind of response I got on this issue as I have seen this mentioned in quite a few posts by folks who have had cervical surgery. Personally I had ACDF with titanium plates and screws on Sept 17th. Before the surgery I was aware of pain in my neck, in my arms, hands and fingers (and some numbness) but I don't remember having pain in my shoulders. Right after surgery I had a lot of shoulder and neck pain but the NS said it was due to positioning during surgery and would go away. However it did not go away and I have been going for Physical Therapy. The PT was supposed to be for my neck but we spend a lot of time working on my right shoulder. The PT says I have "soft tissue disfunction" whatever that is. Bottom line I have some left over nerve pain and numbness in my right arm, hand and fingers that I hope will go away in time and I have a lot of pain and problems with my right shoulder that I am working hard to help improve.

So anyone else with shoulder problems after Cervical surgery and if yes what are you doing about the problems.

LJ
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13

Comments

  • i didnt have any troubles until i was in an accident and oh well its all in my signature line #:S . i thought maybe something was wrong with me having all this pain after surgery, until i found this forum and also i didnt even know what "acdf" ment. after learning some things and then asking questions at my ns appointments, i now realize the different life i am blessed to live. good luck on your recovery and i will also say a prayer for u and your family.
  • LJ Like you I do not remember having shoulder pain before surgery. The shoulder pain is always there since my surgery 4 1/2 months ago. It becomes more intense with weather changes especially cold weather & rain, & upon awaking.
  • I thought I was weird. Now I see i'm normal. That's always good to know. I'm in PT now for my neck but called the therapist yesterday to ask if we could focus more on my shoulder pain instead. She told me I have shoulder pain because of my neck. So we continue to work on my neck strengthening exercises and stimulation and heat. It seems like every pain I have down to my toes points all the way back to my neck. I never realized how connected all of these things are. I see that our surgeries were a few days apart. What are you doing in PT for your neck?
  • Hi KC,
    I'm like you, until I found this forum I did not even know what ACDF meant. Of course I went a little crazy researching stuff before surgery to the point my NS said "stay off the internet" LOL. But he was kidding and he was happy that I understood what was going on.
    I'm sorry that you still have problems but I am beginning to think that after this type of surgery (at least the multi level ones) that we can't expect to be 100%. I am glad to have recovered most of the feeling in my fingers and hands and hopefully the PT will help with some of the other issues. Some of it I guess I will just live with (not like I haven't lived with it for a awfully long time already). Thanks for the prayer, I am a firm believer in the power of prayer and will say one for you as well.
    LJ
    24-7 stiff neck said:
    i didnt have any troubles until i was in an accident and oh well its all in my signature line #:S . i thought maybe something was wrong with me having all this pain after surgery, until i found this forum and also i didnt even know what "acdf" ment. after learning some things and then asking questions at my ns appointments, i now realize the different life i am blessed to live. good luck on your recovery and i will also say a prayer for u and your family.
  • Hi gulfpearl,
    I wish the doctors would do a study on the shoulder pain after ACDF.
    I hope that your's will improve in time. I know what you mean about the weather. Its raining today and my shoulder is so NOT HAPPY.
    LJ
    gulfpearl said:
    LJ Like you I do not remember having shoulder pain before surgery. The shoulder pain is always there since my surgery 4 1/2 months ago. It becomes more intense with weather changes especially cold weather & rain, & upon awaking.
  • Tonya,

    ....first the disclaimer, I am not in the medical field and the opinions I express are just that my own opinions.

    You asked what I am doing in PT for my neck. First they have me put heat or cold packs on my neck for 10 minutes (cold if she wants to use cold lazer). Then the physical therapist works on my neck and shoulder. She does massage type things and sometimes uses cold lazor treatment or once I had a different PT and she used ultra sound. Ultra sound scares me because they have to stay away from the neck because it can effect fusion. The physcial therapist does most of her work on my right shoulder. After the PT is done working on me she will have me do some neck exercises. Most of them are isometric (limited movement). She has me lay on my back, tuck my chin and just barely raise my head off the table and then hold for a count of 2 or 3. She has me do this about 10 times. We did not start this exercise until my 4th week of PT and it is painful to do. I also do chin tucks, which is just tucking your chin in slightly a series of times. I work in the gym also. They have me use pullies that hang from the ceiling (no weight) and you move your arms up and down slowly while turning your neck in the opposite direction. I work with a big ball, holding my hand on the top of the ball with the ball on a table and rolling the ball very slightly back or forward while slightly turning my neck in the other direction. I also do something with a ball behind my back while I sit on a table and the ball is against a wall and I kind of pinch my shoulder blades toward each other. Also work with a hand bike with no weight for 2 minutes forward and 2 back. This is getting awfully long. There are some additional isometric exercise for my neck (limited movements) to strengthen short muscles since the PT says we tend to use long muscles after surgery when we should be using short ones.
    Please don't do any of these yourself without doctor and/or PT approval.
    Get better soon,
    LJ
    tonya42 said:
    I thought I was weird. Now I see i'm normal. That's always good to know. I'm in PT now for my neck but called the therapist yesterday to ask if we could focus more on my shoulder pain instead. She told me I have shoulder pain because of my neck. So we continue to work on my neck strengthening exercises and stimulation and heat. It seems like every pain I have down to my toes points all the way back to my neck. I never realized how connected all of these things are. I see that our surgeries were a few days apart. What are you doing in PT for your neck?
  • I could have written your first post =(( My shoulder was fine until I had a 2-level acdf on 10/30. When I went to see my surgeon for my 2-week follow-up, he said it was probably due to surgical positioning and would resolve quickly. He gave me Voltaren gel that I could apply to my shoulder area only - it did not help it the least. He did mention PT if the pain is not resolved be my appt on 12/9.

    The pain, at times, in intolerable. It feels like there is a BP cuff inflated to the maximum level on my upper arm. It is a burning pain.

    Keep us posted.

    Take care,
    Elle
  • Hi LJ,

    I understand completely what you are going through. I had a revision of an ACDF at C5-C6 this past May (I fell on ice in March and sheared it off :( ) Anyhow, that surgery was great and I felt relief almost immediately. I too had a lot of spasms in my right shoulder and was told the same thing by the orthopedist.

    I was only able to do 4 sessions of PT before telling him something was not right. After each session I had to come home and re-apply heat pads and use the TENS unit and take Flexerils just to get through the rest of the day. I knew something wasn't right and thankfully the ortho listened to me and got right on the problem. Turned out there was herniations and compresion in the rear of my neck from the original fall 12 years ago and the spasms I had all these years were related to that :/ eventho the whole world told me it was all in my head. Anyhow, I am just finishing recovery from a foraminotomy (they opened the nerve root pathways from the spinal cord on the rear of the spine) and wired some of the discs together in the back to keep them more stable until the muscles strengthen.

    For the first time in YEARS I am pain free, all because I pushed the doc to keep checking things out. I had to tell him I wasn't blaming him for anything right or wrong, I just wanted to be out of pain and stop having migraines.

    Nearly two months postop and I haven't had a headache nor migraine, and my arms, hands and fingers don't burn for the first time in 12+years.

    Get the doc to check again. Be aggressive and don't do what I did after my first surgery: settle for the standard answer. You're the one who owns the body, and who knows what is happening; the doc goes home at night and gets a good night's sleep. Get an MRI, and I recommend one where you are standing if they have that machine nearby, to replicate the normal position of your head and spine.

    Good luck
  • LJ,

    I also had terrible shoulder pain after my surgery. Before surgery I had pain in my right shoulder only but after surgery the pain was in both shoulders. It was so bad I would wake up up several times each night from the pain. Also, going back to work in front of a computer seemed to make it worse. Until I saw the title of your thread I didn't even realize it was gone! I have been so focused on the things that are still causing me pain I have not taken the time to be grateful for the things that have improved. I had surgery on 7-11-08 and I guess the shoulder pain went away after I went to physical therapy several times...probably about a month ago.

    I appreciate you posting the info about your PT. My doctor changed the organization that does my PT because I didn't feel like I was making much progress. After reading all that you do in therapy I'm sure I made the right decision. I went 14 times and we only did the same three or four things each time...not near as much as you do at your session. Hopefully, the new therapist will take a more aggressive approach because I definitely want to get better (but not over-do it)



  • And I thought my Therapist was mean. :) We are just doing your general strengthening exercises for my neck. She keeps adding a new one every time I see her though. We do heat and stimulation every time. This last time we added ultra sound. I thought that sounded great until I had to drag myself out of my car the other night. I'm going to lay off PT until I see my doc next Wed. about my new lower back issue. Geez.... Does it ever end? Sounds like you get quite the workout! My shoulder is getting better though since my last post so I know we are doing something right. I just don't know what we did that was so wrong the other night. i'm kind of bummed about not doing PT because it must have been working. Oh and let me tell you. My therapist had someone helping her the other day and he came up to one exercise and had me lay face down on a table. And what happened next was like a scene out of "The Matrix". My therapist is screaming NOOOOO!!!! and comes running across the room. She just had ACDF. No turning her head! I was just laying there scared to move after her screams. She helped me off the table and apologized. :)
  • neck and rotator cuffs both sides and elbow on left side and right hand, all nerve stuff.
  • Elle,
    sorry to hear that you are still having pain. Hopefully you will continue to get better since your surgery was fairly recent.

    Jim,
    I'm glad you are now pain free but sounds pretty awful that it took so long and that you needed more surgery to get to this point. That scares me to death, the possiblity of more surgery.

    Kathal,
    I'm glad your pain is better and you are still doing PT.

    Tonya,
    Sounds like you need to be very careful in PT and make sure anyone that works with you knows exactly what you had done. I had one of the assistants try to give me something to do with weights one day and I was quick to tell him that I am not to use weights and then my therapist came over to tell him also. They see so many people that sometimes they don't realize what exactly we had done. If they make a mistake its a mistake but if we listen we are the ones who suffer. I hope you will be able to continue PT because I think it helps just be very vocal about what works and what does not. I usually work with one of two people and the one I work with less had me do an exercise laying on my back and tucking my chin and lifting my head slightly. This is fine for a second or two but she had me hold for 10 seconds. by they my whole body was shaking and I was in serious pain. I said I will continue to do this exercise but I want to start slow and work my way up over time.

    Mabun
    Sounds like you still have a lot of nerve related issues and unfortunately I seem to as well. I thought I was getting some improvement and then unfortunately I overdid on Wednesday and Thursday for Thanksgiving and now both my shoulders are back in spasm and I have pain in the center of my shoulders and upper back. I always have nerve related pain in my right hand and arm but I am still very hopeful that most of this will resolve in time. I just need to keep reminding myself that I can't do a lot of things that I want to for now. I hope you get a lot better,
    LJ
  • I think I found a new form of PT that I don't have to pay for. For the first time in 2 months I babysat for my daughter in law while she went to have her hair done. He's a handful at 8 months old. He's already trying to walk and can actually take a few steps now without falling. Now I'm wondering if I shouldn't just keep him more often and keeping my copay in my pocket. :))) Actually I think I'm going to ask that we just work on strengthening exercises and intend to ask about some of the thing that you mentioned. I can do heat at home and I'm afraid of the ultrasound now.
  • My surgeon told me before the surgery that I was going to have really bad shoulder pain. And a lot of pain between the shoulders as well. He said it was due to the repositioning of the all of the tendons and muscles of the neck that were so used to "guarding" and because my neck was being strengthened and straightened.
    He wasn't kidding. There were days in the first few weeks that it felt like someone was trying to rip my arm off at my shoulder (like a chicken wing).
    I'm 6 weeks post-op and I went to a party this weekend and even with my collar on, I was looking around and talking, etc. The next day my shoulders - OooohEeee!
  • Tonya,
    Wow, babysitting an 8 month old. I hope you were extra careful. I would not think you would be allowed to pick him up. Strengthening exercises sound like a good idea. Your PT should be open to suggestion as long as it fits into things that are good for you and won't hurt you. The PT I see the most is really good. She listens to me and depending on what I am feeling she adjusts the days PT. I just wish my shoulders would feel better. I am used to neck pain but I wish this pain would ease up already.
    LJ
    tonya42 said:
    I think I found a new form of PT that I don't have to pay for. For the first time in 2 months I babysat for my daughter in law while she went to have her hair done. He's a handful at 8 months old. He's already trying to walk and can actually take a few steps now without falling. Now I'm wondering if I shouldn't just keep him more often and keeping my copay in my pocket. :))) Actually I think I'm going to ask that we just work on strengthening exercises and intend to ask about some of the thing that you mentioned. I can do heat at home and I'm afraid of the ultrasound now.
  • I find it very interesting that so many of us that had ACDF surgery have the same type of shoulder issues. My PT said that stuff about guarding. When our neck hurts we tend to protect it. Who knew it was going to create all these other issues. I had planned to go back to work in Nov after 8 weeks but I am still out now at 10 weeks post op. Most likely I will return to work right after the new year. I have a ton of vacation time and I am going to see if I can "offically" return to work but use my vacation till Jan so I can continue to recover and do PT but bring home a little more money then the disability is paying me. I will lose several weeks of vacation time if I don't take it so it seems like a good idea to me.
    LJ
    phxchele said:
    My surgeon told me before the surgery that I was going to have really bad shoulder pain. And a lot of pain between the shoulders as well. He said it was due to the repositioning of the all of the tendons and muscles of the neck that were so used to "guarding" and because my neck was being strengthened and straightened.
    He wasn't kidding. There were days in the first few weeks that it felt like someone was trying to rip my arm off at my shoulder (like a chicken wing).
    I'm 6 weeks post-op and I went to a party this weekend and even with my collar on, I was looking around and talking, etc. The next day my shoulders - OooohEeee!
  • I went back after 7 weeks and I'm afraid I'm paying the price for it. I work in IT so I sit in front of the computer most of the day but I do lots of walking too to fix other people's computers. But when I get home oh how I just want my pain pill, recliner and heating pad. I took 2 weeks of vacation right after my surgery which was really only 2 days since I have been working from home through all of this. We I think are the fortunate few. I was in the same situation as you. I've been with this company for 8 years and have 220 hrs of vacation time. So it came down to use it for lose it. But this is no way to spend a vacation.
  • I had my surgery in June and all my back pain was fixed! But after a few months doing PT and all that, my right shoulder blade, like under the shoulder blade keeps getting knots in it and it like zings up to my neck. got x-rays and a mri again to see whats going on, they said its because the bones aren't fusing or growing.... doc ordered a bone stimulator and told me to put the soft collar back on :( so here i am again *sighs* But i still cant help but think there is something else going on, so when i go back in Jan. and the bones are growing back and if i still have shoulder pain..yea i will still be upset! Curious if anyone has gone through this yet or if it ever goes away.
  • My shoulder pain started this past May and that was 13 months after my surgery. I struggled with it until July and went to my ortho doctor, not my surgeon but all in the same practice. He felt stuck in the middle not knowing what to do since I had neck surgery....could not get in to see my surgeon until October so he did an injection and ordered PT.....after all this and still no better he ordered an MRI which showed "blunting"....PT finally hit the nail on the head when she mentioned the postion that I was put in for posterior cervical spine surgery. I remember when I woke up from surgery my primary pain was left arm and shoulder pain. Did see my surgeon in Oct who ordered an myelogram which showed bulging disc above fusion...I also got another set of injections, 5 very painful injections in the shoulder area, done by a shoulder surgeon. As of right now my shoulder is much better and I am praying it stays that way. I think after cervical spine surgery shoulder problems will follow. I still wonder if something did not happen during my surgery to cause this. It was a 6 hours surgery and if anyone has ever googled posterior cervical spine surgery you will see what I am talking about when I say "position"

    Sharon
  • LJ said:
    I have a ton of vacation time and I am going to see if I can "offically" return to work but use my vacation till Jan so I can continue to recover and do PT but bring home a little more money then the disability is paying me. I will lose several weeks of vacation time if I don't take it so it seems like a good idea to me.
    My doctor sent me back to work three weeks post op from a level 2 ACDF. If you can stay home you should. That was WAY too early to go back and I was in terrible pain. My company lets us use vacation time in lieu of sick time if we want and we don't have to officially return to work. Maybe your place of work would let you do that too - it might not hurt to ask. Since our vacation is also a "use it or lose it" policy we can replace sick time with vacation.

    I wanted to tell you also that I had my first appt. with the new PT today. I went in with fairly severe pain and tonight it's not as bad as it normally is. (Finally!) She did things my old PT did not do and it really helped. I think I am going to be very pleased with this organization.
  • What is blunting? I have alot of pain but mine was ACDF. So I cannot for the life of figure out why my back muscles hurt so bad since I was laying on my back but did have a 5 lb weight on my head. Does anyone think that would have something to do with it? Maybe having my head held back in that position for the surgery. Mine was really quick in and and out it was just very typical. LJ I'm not guarding my neck. Since I didn't have a collar I can't even blame it on that. Does anyone out there know and can tell me what muscle gets moved during surgery other than the long muscle in the front of your neck?
  • I have no clue what blunting means. I got a copy of my MRI report and that was what it reads, indicates a possible tear. From what the shoulder surgeon tells me, surgery on the shoulder is the last thing your want to do. The recoup time is very very long. He ask me about any injuries, which there are none. After my surgery I was very careful and in no way injured my shoulder. That is why I believe it has something to do with the position during neck surgery. The posterior position is horrible and to be in that position for 6 hours, who knows. It's not like the hospital or the staff are going to tell you anything. Again, these are just my thoughts. I never had problems with my shoulder before surgery.

    Sharon
  • I have an appointment with my doc today to actually talk about the results of my lower back MRI results. Everybody say a prayer for me. I want to hear that he found nothing there and it must have something to do with my cervical surgery. I just hope it's all the pressure from my neck. But while I'm there I want to talk to him about all of the shoulder pain. He did forewarn me but I really thought or hoped at least it would be gone by now. It's the only reason I continue to take medication and I don't want swallow not one more pill. I may print out our very long post here and take it with me. Maybe he has an answer for us all. I just want to wake up one morning with NO pain. Just one is all I'm asking for.
  • Kathal,
    I am surprised you went back to work after 3 weeks. Our company uses a "medical management group" to make recommendations on disability. They told me the average DB for one level ACDF is 58 days and for three levels is 90 days, so 3 weeks was really early and not fair to you. I'm glad you like your new PT and hope it continues to work well for you. I just got home from PT (which is always the best time and least painful for me to be on the computer).
    LJ
  • Tonya,
    I am so sorry you are still having pain problems. Hearing stuff like this is one of the reasons I am not in a hurry to return to work. I still have a lot of pain and I am afraid what sitting in front of a computer all day will do to me. I work on a computer all day or I am traveling for work (either one is not a lot of fun with neck and shoulder pain). I'm hoping if I manage to stay out the rest of the month that the PT will start kicking in. I can just see this shoulder thing becoming cronic and I really hope it does not.
    LJ
    tonya42 said:
    I went back after 7 weeks and I'm afraid I'm paying the price for it. I work in IT so I sit in front of the computer most of the day but I do lots of walking too to fix other people's computers. But when I get home oh how I just want my pain pill, recliner and heating pad. I took 2 weeks of vacation right after my surgery which was really only 2 days since I have been working from home through all of this. We I think are the fortunate few. I was in the same situation as you. I've been with this company for 8 years and have 220 hrs of vacation time. So it came down to use it for lose it. But this is no way to spend a vacation.
  • Hi MD,
    I have used a bone stimulator since a few days after my surgery. At about 6 weeks fusion was just barely beginning at two of the three levels with grafts. I never wore a collar (my doctor is one of those that does not believe in collars). I am due back at the doctor the first week of Jan and very interested in knowing how my fusion has progressed. I hope the bone stimulator helps you. Seems like a long time for the bones not to be fusing. However I don't see how the non fusion could be responsible for the shoulder pain. I started out with pain in the right shoulder and recently started having pain in the left as well. The PT always says I have a lot of inflammation.
    LJ
    morningdew said:
    I had my surgery in June and all my back pain was fixed! But after a few months doing PT and all that, my right shoulder blade, like under the shoulder blade keeps getting knots in it and it like zings up to my neck. got x-rays and a mri again to see whats going on, they said its because the bones aren't fusing or growing.... doc ordered a bone stimulator and told me to put the soft collar back on :( so here i am again *sighs* But i still cant help but think there is something else going on, so when i go back in Jan. and the bones are growing back and if i still have shoulder pain..yea i will still be upset! Curious if anyone has gone through this yet or if it ever goes away.
  • Shar,
    I am glad your shoulder is feeling better and I also hope it continues to feel good for you. I really wonder if position has something to do with the shoulder pain both anterior and posterior. I just wish there was some medical research on this topic but I haven't been able to find any so I guess we are making our own.
    LJ
  • The guarding idea comes from my PT and she said it happens before surgery when we have neck pain. Seems weird to me that something that causes no pain before surgery, would cause pain after.
    LJ
  • Hi Tonya,
    It would be great if your doctor has some idea what causes the shoulder pain. I hope you have a good appointment today. I'm with you on wanting to wake up one day without pain but I want a lot more then one day. :D
    LJ
    tonya42 said:
    I have an appointment with my doc today to actually talk about the results of my lower back MRI results. Everybody say a prayer for me. I want to hear that he found nothing there and it must have something to do with my cervical surgery. I just hope it's all the pressure from my neck. But while I'm there I want to talk to him about all of the shoulder pain. He did forewarn me but I really thought or hoped at least it would be gone by now. It's the only reason I continue to take medication and I don't want swallow not one more pill. I may print out our very long post here and take it with me. Maybe he has an answer for us all. I just want to wake up one morning with NO pain. Just one is all I'm asking for.
  • My back is fine. That's the good news. :D The bad news. He still can't won't or doesn't want to tell me why my shoulders hurt. He did warn me before surgery that it would happpen so it's not that I didn't expect it. I just didn't expect it to last this long. He just offered to refill my prescriptions and off I went still scratching my head. I thought about printing this thread out and mailing it to him just to see what he REALLY thinks. He did say it was from the muscles being moved around but I still can't help but wonder if it is something else.
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